Sports Medicine

, Volume 2, Issue 4, pp 237–247 | Cite as

Anorexia Nervosa and Exercise

Implications from Recent Findings
  • James A. Blumenthal
  • Sandra Rose
  • Jonathan L. Chang
Leading Article


Recently, the potential abuses of excessive exercise have received a great deal of attention. Several researchers, most notably Yates and colleagues (1983), have suggested that the habitual runner resembles the male equivalent of the patient with anorexia nervosa. Our review of the two modes of behaviour, however, provided little empirical support for the proposed analogy. Indeed, most evidence suggests that while anorexia nervosa represents a serious medical disorder, running is generally an adaptive form of behaviour that often serves to enhance physical and psychological functioning. Instead of a disease model of running, we propose that running represents one method by which individuals learn to regulate their emotional states.


Negative Affect Anorexia Nervosa Eating Disorder Anorectic Patient Human Kinetic Publisher 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. American Psychiatric Association: DSM-III: Diagnostic and Statistical Manual of Mental Disorders. 3rd ed. (American Psychiatric Association, Washington, D.C. 1980).Google Scholar
  2. Baekeland, F.: Exercise deprivation. Archives of General Psychiatry 22: 365–369 (1970).PubMedCrossRefGoogle Scholar
  3. Bemis, K.M.: Current approaches to the etiology and treatment of anorexia nervosa. Psychological Bulletin 85: 593–617 (1978).PubMedCrossRefGoogle Scholar
  4. Bittker, T.: Runners gluttony. Runner’s Work 12: 10–11 (1977).Google Scholar
  5. Blumenthal, J.A.; Williams, R.S.; Williams, Jr, R.B. and Wallace, A.G.: Effects of exercise on the Type A (coronary prone) behaviour pattern. Psychosomatic Medicine 42: 289–296 (1980).PubMedGoogle Scholar
  6. Blumenthal, J.A.; Williams, R.S.; Needels, T.L. and Wallace, A.G.: Psychological changes accompany aerobic exercise in healthy middle-aged adults. Psychosom. Med. 44: 529–536 (1982).PubMedGoogle Scholar
  7. Blumenthal, J.A.; O’Toole, L.C. and Chang, J.L.: Is running an analogue of anorexia nervosa? An empirical study of obligatory running and anorexia nervosa. Journal of the American Medical Association 252: 520–523 (1984).PubMedCrossRefGoogle Scholar
  8. Boyer, J.L. and Kasch, F.W.: Exercise therapy in hypertensive men. Journal of the American Medical Association 211: 1668–1671 (1970).PubMedCrossRefGoogle Scholar
  9. Bruch, H.: Eating Disorders: Obesity. Anorexia Nervosa, and the Person Within (Basic Books, New York 1973).Google Scholar
  10. Bruch, H.: The Golden Cage (Harvard University Press, Massachusetts 1978).Google Scholar
  11. Burfoot, A.: Compulsive running. Runners World 18: 96–168 (1983).Google Scholar
  12. Clitsome, T. and Kostrubala, T.: A psychological study of 100 marathoners using the Myers-Briggs type indicator and demographic data. Annals of the New York Academy of Science 301: 1010–1019 (1977).CrossRefGoogle Scholar
  13. Colt, E.W.D.; Dunner, D.L.; Hall, K. et al.: A high prevalence of affective disorder in runners; in M.H. Sacks and M.L. Sachs (Eds) Psychology of Running (Human Kinetics Publishers, Illinois 1981).Google Scholar
  14. Cowan, G.O.: Influence of exercise on high-density lipoproteins. American Journal of Cardiology 52: 13B–16B (1983).PubMedCrossRefGoogle Scholar
  15. Crisp, A.H.: Some aspects of the evolution, presentation and follow-up of anorexia nervosa. Proceedings of the Royal Society of Medicine 58: 814–820 (1965).PubMedGoogle Scholar
  16. Crisp, A.H.: The possible significance of some behavioral correlates of weight and carbohydrate intake. Journal of Psychosomatic Research 11: 117–131 (1967).PubMedCrossRefGoogle Scholar
  17. Crisp, A.H.; Hsu, L.K.G.; Harding, B. and Hartshorn, J.: Clinical features of anorexia nervosa: A study of a consecutive series of 102 female patients. Journal of Psychosomatic Research 24: 179–191 (1980).PubMedCrossRefGoogle Scholar
  18. Crisp, A.H.; Palmer, R.L. and Kalucy, R.S.: How common is anorexia nervosa? A prevalence study. British Journal of Psychiatry 128: 549–554 (1976).PubMedCrossRefGoogle Scholar
  19. Dishman, R.K.: Compliance/adherence in health-related exercise. Health psychology 3: 237–267 (1982).CrossRefGoogle Scholar
  20. Drossman, D.A.; Ontjes, D.A. and Heizer, W.D.: Anorexia nervosa. Gastroenterology 77: 1115 (1979).PubMedGoogle Scholar
  21. Epling, W.F.; Pierce, W.D. and Stefan, L.: A theory of activity-based anorexia. International Journal of Eating Disorders 3: 27–46 (1983).CrossRefGoogle Scholar
  22. Eysenck, H.J.. Nias, D.K.B. and Cox, D.N.: Sport and personality. Advances in Behavior Research Therapy 4(1): 1–55 (1982).CrossRefGoogle Scholar
  23. Fears, W.B.; Glass, A.R. and Vigersky, R.A.: Role of exercise in the pathogenesis of the amenorrhea associated with anorexia nervosa. Journal of Adolescent Health Care 4: 22–24 (1983).PubMedCrossRefGoogle Scholar
  24. Feighner, J.P.; Robin, S.E. and Guze, S.: Diagnostic criteria for use in psychiatric research. Archives of General Psychiatry 26: 57–63 (1972).PubMedCrossRefGoogle Scholar
  25. Folkins, C.H. and Sime, W.E.: Physical fitness training and mental health. American Psychologist 36: 373–389 (1981).PubMedCrossRefGoogle Scholar
  26. Glasser, W.: Positive Addiction (Harper and Row, New York 1976).Google Scholar
  27. Gontang, A.; Clitsome, T. and Kostrubala, T.: A psychological study of 50 sub 3-hour marathoners. Annals of the New York Academy of Sciences 301: 1020–1028 (1977).CrossRefGoogle Scholar
  28. Gull, W.W.: Anorexia nervosa (apepsia hysterica. anorexia hysterica). Transactions of the Clinical Society 7: 22–28 (1874).Google Scholar
  29. Halmi, K.A.: Anorexia nervosa: Demographic and clinical features in 94 cases. Psychosomatic Medicine 36: 18–26 (1974).PubMedGoogle Scholar
  30. Halmi, K.A.: Anorexia nervosa and bulimia. Psychosomatics 24: 111–129 (1983).PubMedCrossRefGoogle Scholar
  31. Halmi, K.; Brodland, G. and Rigas, C.: A follow-up study of seventy-nine patients with anorexia nervosa: An evaluation of prognostic factors and diagnostic criteria. Life History Research in Psychopathology 290–300 (1975).Google Scholar
  32. Harber, V.J. and Sutton, J.R.: Endorphins and exercise. Sports Medicine 1: 154–171 (1984).PubMedCrossRefGoogle Scholar
  33. Harris, L. and Associates: The Prevention Index: A report card on the nation’s health. Prevention. A project of the Prevention Research Center (Rodale Press 1983).Google Scholar
  34. Hartung, G.H. and Farge, E.J.: Personality and physiological traits in middle-aged runners and joggers. Journal of Gerontology 32: 541–548 (1977).PubMedCrossRefGoogle Scholar
  35. Hill, O.W.: Epidemiologic aspects of anorexia nervosa. Advances in Psychosomatic Medicine 9: 48–62 (1977).Google Scholar
  36. Johnson, R.W. and Morgan, W.P.: Personality characteristics of college athletes in different sports. Scandinavian Journal of Sports Science 3(2): 41–49 (1981).Google Scholar
  37. Kay, D.W.K. and Leigh, D.: The natural history, treatment, and prognosis of anorexia nervosa. based on a study of 38 patients. Journal of Mental Science (British Journal of Psychiatry) 100: 411–431 (1954).CrossRefGoogle Scholar
  38. Kentala, E.: Physical fitness and feasibility of physical rehabilitation after myocardial infarction in men of working age. Annals of Clinical Research 4(Suppl. 9): 1–94 (1972).PubMedGoogle Scholar
  39. King, A.: Primary and secondary anorexia nervosa syndromes. British Journal of Psychiatry 109: 470–479 (1963).PubMedCrossRefGoogle Scholar
  40. Lasegue, E.C.: On hysterical anorexia (De l’anorexie hysterique); in R.M. Kaufman and M. Heiman (Eds and Trans) Evolution of Psychomatic Concepts: Anorexia Nervosa: A Paradigm, pp. 141–155 (International Universities Press, New York 1964).Google Scholar
  41. Leehey, K.: Letter to the editor. Psychiatric News, November 14 (1984).Google Scholar
  42. Little, J.C.: Athletes neurosis: A deprivation crisis. Acta Psychiatrica Scandinavica 45: 187–197 (1969).PubMedCrossRefGoogle Scholar
  43. Little, J.C.: Neurotic illness in fitness fanatics. Psychiatric Annals 9: 55–56 (1979).Google Scholar
  44. McSherry, J.A.: The diagnostic challenge of anorexia nervosa. American Family Physician 29: 141–145 (1984).PubMedGoogle Scholar
  45. Moodie, D.S. and Salcedo, E.: Cardiac function in adolescents and young adults with anorexia nervosa. Journal of Adolescent Health Care 4: 9–14 (1983).PubMedCrossRefGoogle Scholar
  46. Morgan, W.P.: Negative addiction in runners. Physician and Sports Medicine 7: 57–70 (1979).Google Scholar
  47. Morgan, W.P. and Costill, D.L.: Psychological characteristics of the marathon runner. Journal of Sports Medicine 12: 42–46 (1972).Google Scholar
  48. Morgan, W.P. and Pollock, M.L.: Psychologic characterization of the elite distance runner. Annals of the New York Academy of Science 301: 382–402 (1977).CrossRefGoogle Scholar
  49. Morris, J.N.; Everitt, M.G.; Pollard, R.; Chave, S.P. and Sommence, A.M.: Vigorous exercise in leisure-time: Protection against coronary heart disease. Lancet 2: 1207–1210 (1980).PubMedCrossRefGoogle Scholar
  50. Nakao, K.; Nakai, Y.; Oki, S.; Matsubara, S.; Konishi, T. et al.: Immunoreactive β-endorphin in human cerebrospinal fluid. Journal of Endocrinology and Metabolism 50: 230–233 (1980).CrossRefGoogle Scholar
  51. Nylander, T.: The feeling of being fat and dieting in a school population. Acta Sociomedicine Scandinavian 3: 17–26 (1971).Google Scholar
  52. Paffenbarger, R.S.; Wing, A.L. and Hyde, R.T.: Physical activity as an index of heart attack risk of college alumni. American Journal of Epidemiology 108: 161–175 (1978).PubMedGoogle Scholar
  53. Paffenbarger, R.S.; Hyde, R.T.; Wing, A.L. and Steinmetz, C.H.: A natural history of athleticism and cardiovascular health. Journal of the American Medical Association 252: 491–495 (1984).PubMedCrossRefGoogle Scholar
  54. Renfrow, N.W. and Bolton, B.: Personality characteristics associated with aerobic exercise in adult males. Journal of Personality Assessment 43: 261–266 (1979).PubMedCrossRefGoogle Scholar
  55. Rogers, D.A.: Minnesota Multiphasic Personality Inventory; in Buros (Ed.) Seventh Mental Measurements Yearbook, p. 242 (Gryphon Press, New Jersey 1972).Google Scholar
  56. Sachs, M.L.: Running addiction; in M.H. Sacks and M.L. Sachs (Eds) Psychology of Running, pp. 116–126 (Human Kinetics Publishers, Champaign 1981).Google Scholar
  57. Sours, J.A.: Starving to death in a sea of objects: The anorexia nervosa syndrome, pp. 259–260 (Jason Aronson, New York 1980).Google Scholar
  58. Thaxton, L.: Physiological and psychological effects of short term exercise addiction on habitual runners. Journal of Sport Psychology 4: 73–80 (1982).Google Scholar
  59. Tomkins, S.: Psychological model for smoking behaviour. American Journal of Public Health 66: 17–20 (1966).Google Scholar
  60. Tomkins, S.: A modified model of smoking behaviour; in E.F. Borgatta and R.R. Evans (Eds) Smoking. Health and Behaviour (Aldine, Chicago 1968).Google Scholar
  61. Vranic, M. and Berger, M.: Exercise and diabetes mellitus. Diabetes 28: 147–163 (1979).PubMedGoogle Scholar
  62. Yates, A.; Leehey, K. and Shisslak, C.: Running: An analogue of anorexia? New England Journal of Medicine 308: 251–255 (1983).PubMedCrossRefGoogle Scholar

Copyright information

© ADIS Press Limited 1985

Authors and Affiliations

  • James A. Blumenthal
    • 1
    • 2
  • Sandra Rose
    • 1
    • 2
  • Jonathan L. Chang
    • 1
    • 2
  1. 1.Department of PsychiatryDuke University Medical CenterDurhamUSA
  2. 2.Department of MedicineUniversity of Virginia Medical SchoolCharlottesvilleUSA

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